Prozac Not Effective Against Anorexia

A study finds the antidepressant is unsuccessful at preventing relapses of the eating disorder.

The antidepressant Prozac works no better than a placebo in preventing relapses in patients with the eating disorder anorexia nervosa, according to a study released Tuesday.

The report in the Journal of the American Medical Association sent researchers back to square one in the search for drugs to treat the intractable disorder, which affects mostly women and adolescent girls.

"This is not good news," said Dr. Marsha Marcus, an eating disorder specialist at the University of Pittsburgh not involved in the study. "What this highlights for me is that we really desperately need new treatments."

People with anorexia are obsessed with their body weight and diet to the point where they become dangerously thin. Half the people with the disorder binge on food and then purge by vomiting or using laxatives or diuretics. The other half restricts the food they eat and exercises excessively. The disorder affects 1 percent to 2 percent of females in the U.S. and leads to death in an estimated 10 percent of cases.

Standard treatment for the disorder is behavioral therapy; in severe cases, patients are hospitalized to restore their weight. The relapse rate in the worst cases is high -- up to half of hospitalized patients are readmitted within a year.

The study set out to determine whether Prozac, generically known as fluoxetine, would enhance the benefits of behavioral therapy. Researchers looked at Prozac because it was commonly prescribed for anorexia nervosa, although the drug has not been approved for the condition.Dr. B. Timothy Walsh of Columbia University, lead author of the report, said there were reasons to believe Prozac would be effective.

The drug had been shown to prevent relapses in patients with bulimia, an eating disorder with some similarities to anorexia, he said. People with bulimia binge eat and purge but maintain a normal weight. In addition, Walsh said, a small previous study in anorexia nervosa patients had hinted that Prozac could postpone relapses.

The latest research, conducted at Columbia University and the University of Toronto, included 93 females ages 16 to 45 who had been diagnosed with the eating disorder. Patients entered the study after regaining weight to a minimum body mass index of 19 after intensive inpatient or outpatient treatment. BMI is a standard measure that takes into account a person's weight and height. *